Objective To evaluate the diagnosis, treatment and prognosis of occult breast cancer(OBC). Methods Clinical data of 12 OBC cases from June 1995 to June 2006 were retrospectively analyzed.Results There were 12 female; the mean age was 52.7 years(39～66). Tumor of all cases was in one of breasts, left(10 cases) or right(2 cases), 4 cases in pro- menostasis, 8 cases in post-menopause, and inci-dence of OBC in all kinds of breast cancer was 0.5% (12/2385). All cases were found because of lump in axillary fossa, the biopsy of 10 showed cases were lymph node adenocarcinoma metastatic, the fine needle aspiration of 2 cases were lymph node adenocarcinoma metastatic. Three cases were positive in the determi-nation of estrogen receptor of lymph node adenocareinoma metastatic. Two cases, suspecting breast cancer,could be found fine calcification in the examination of breast X-ray molybdenum target in 10 cases. Buhra-sound in 11 cases and near infrared ray scan in 10 cases did not detect cancer in breast; chest X-ray and Bultrasound in 10 cases and CT and all over the body bone scan in 5 cases did not found any cancer besides breast. Ten cases used modified radical mastectomy for breast cancer, one case radical mastectomy for breast cancer, one palliative operation. Pathological diagnosis of 9 cases after operation found breast primary le-sion, 6 cases were infiltrated duct cancer, 3 eases were intraductal cancer. All cases received radiotherapy and chemotherapy. Three cases which were positive in the determination of estrogen receptor of lymph node adenocarcinoma metastatic received TAM. Followed-up was made from 3 to 10 years, 11 cases were not found recurrence or metastses, and 5 cases had been living over 5 years. Conclusions OBC is one of rare special breast cancers. The powerful infiltrating capability leads to lump in axillary fessa in prophase and dis-rant metastses. The biopsy and fine needle aspiration would be used for diagnosis. Modified radical mastecto-my for breast cancer is the usual therapy method.

The technique of RNA interference has been used in the area of cardiovascular system. Chitosan nanoparticles(CS-NP) has been a hotspot of the research due to its good biological characteristics and has a great potential to be used as the carrier for gene delivery. This article gives a simple review the application of the techniques, the currently used preparation methods of CS-NP, the factors that affect the rate of complexing of plasmid with CS-NP, the transfection efficiency of plasmid CS-NP compounds, and its in vitro drug releasing behavior.

Objective To investigate the clinical therapeutic effect of thymosin combined with antibiotics on acute exacerbation of chronic obstructive pulmonary disease in eldly patients ,and its influence on cellular immune function.Methods 60 elderly patients with acute exacerbation of chronic obstructive pulmonary disease were select-ed,by using the method of random number table,they were divided into the treatment group (n =30)and control group (n =30).The control group was given antibiotics and conventional treatment,the treatment group was given thymosin on the basis of treatment of the control group.The clinical curative effect and the influence of the cellular immune function were compared in the two groups.Results The after treatment 1s forced expiratory volume (FEV1 ),FEV1 /FVC(%)and FEV1 /expected value (%)of the treatment group were (1.59 ±0.15)L,(58.83 ± 13.14),(76.13 ±3.21),and those of the control group were (1.31 ±0.11)L,(54.62 ±12.41),(68.74 ±3.01), the differences were statistically significant (t =7.261,6.923,8.793,all P <0.05).After treatment,the clinical symptom score and quality of life score of the treatment group were (3.71 ±0.83),(6.48 ±1.12),which were sig-nificantly lower than those of the control group [(4.71 ±0.79),(7.41 ±0.97)],the differences were statistically significant (t =4.983,4.214,all P <0.05).The total effective rate of the treatment group was 96.7%,which was significantly higher than 70.0% in the control group,the difference was statistically significant (χ2 =7.271,P <0.05).After treatment,the CD +4 ,CD +4 /CD +8 of the treatment group were (41.7 ±5.9),(1.35 ±0.49)respectively, which of the control group were (33.2 ±4.8),(1.89 ±0.65),the differences were statistically significant (t =5.107,3.142,all P <0.05).In terms of incidence of adverse reactions,the difference between the two groups was not statistically significant (P >0.05).Conclusion The clinical effect of thymosin combined with antibiotic therapy in the treatment of acute exacerbation of chronic obstructive pulmonary disease in elderly patients is remarkable,safe and reliable,and can improve the cellular immune function in patients,it is worthy of further clinical application.

Objective To summarize the clinical and imaging characteristics of primary Rosai-Dorfman disease (RDD)in central nervous system in order to understand well its features and improve the diagnosis.Methods The clinical and imaging features in 3 patients with RDD in CNS proved by pathology were retrospectively analyzed in combination with the related literatures.Results The lesions in 2 patients occurred in brain and other lesion in 1 occurred outside the brain.Iso-or slight hyperintensity on T1 WI and marked enhancement of the lesion were found.Single lesion was found in 2 patients near the dura mater and located near the superior sagittal sinus or cervical spinal cord.Multiple lesions in 1 patient were located in the lateral ventricle.Conclusion It’s suggested that single or multiple lesions in dural or spinal meninges located in the midline or near the intracephalic venous system would be considered as RDD in CNS.

Objective: To study the differences of the superficial masseter muscle morphology characteristics between adult high-angle and low-angle facial skeletal types. Methods: The subjects consisted of 37 yellow race adults,17 of them with high-angle facial skeletal type and 20 with low-angle. Ultrasound scanning was used to measure the perimeter, area, width, thickness, and length of masseter muscle. All the items were measured under relaxed, maximal clenching and maximal protrusive mandibular position.Results:①In the various mandibular positions, the masseter muscle size of adults with high-angle facial skeletal type was smaller than that of those with low-angle.②Except for the changes of width from the relaxed to maximal clenching position and from the relaxed to maximal protrusive position(P0.05).③Stature and weight influenced the size of the masseter muscle.Conclusion:The masseter muscle size of adult with high-angle facial skeletal type is smaller than that of those with low-angle.

Background Vitretomy and lenstomy with silicone oil tamponade is an effective method for complicated vitreous retinopathy.The severe anisometropia after silicone retention is usually treated by two-point transscleral suture fixation for posterior chamber intraocular lens(IOL)implantation.In order to reduce the number and difficulty and complication of the operation,the surgical method should be improved.Objective The goal of this study was to observe the resuh of silicone oil removal combined with four-point trans-scleral suture fixation of posterior chamber IOL after vitrectomy.Methods A retrospective case-observational study design was adopted.Twenty eyes with silicone oil tamponade from 20 patients without lens and posterior capsule after vitrectomy were included in this study.Silicone oil removal with four-point trans-scleral suture fixation of posterior chamber IOL was performed.The anterior ocular inflammatory response,intraocular pressure,uncorrected and corrected acuities before and after operation,corneal endothelial cell counting and postoperative complications were observed and analyzed.Written informed consent was obtained from all patients prior to the operation.Results All of the operative eyes in this study showed improvement of visual acuity after operation.Of the 20 eyes,a visual acuity of ≥0.8 was seen in 2 eyes,0.6-0.7 in 6 eyes,0.3-0.5 in 8 eyes and 0.05-0.2 in 4 eyes 3 months after the removal of silicone oil.The uncorrected acuity postoperation was significantly improved in comparison with preoperation(H=10.147,P＜0.01),but no significant difference was found in the corrected acuity between preoperation and postoperation(X =2.089,P＜ 0.01).The number of the corneal endothelial cells was(2064±329)cells/mm2 before operation,and that after operation was(1987±269)cells/mm2,showing an insignificant change between them(t =1.660,P ＞ 0.05).No abnormality of IOL position was found in all 20 operated eyes.There was not serious postoperative complication in all 20 patients.Conclusions The combination of silicon oil extraction with four-point transscleral suture fixation IOL is effective in eyes without posterior capsule or lens after vitrectomy.It can reduce the operation time and improve the postoperative acuity and the quality of life of patients.

Objective To explore the effect of the JAK/STAT signal pathway on the apoptosis-related gene in the synovial tissue of rat rheumatoid arthritis (RA).Methods Fifty rat models of collagen-induced arthritis,whose arthritis index was more than 2,were divided into the model group,the low dose of AG490 group,the medium dose of AG490 group and the high dose of AG490 group.In addition,6 rats were treated intraperitoneal injection.Then,the arthritis index and the change of apoptosis-related genes were compared.Multiple-sample average was analyzed by single-factor x2 test and LSD-t or Tamhane's T 2 test were used for two-two comparison.Results The arthritis index of the model group increased evidently,and the apoptosis inhibitor Bcl-2,Bcl-xl gene and protein expression was up-regulated,which was significantly different when compared with that of the control group(0.931±0.035 vs 0.351±0.024,0.920±0.037 vs 0.271±0.029,0.322±0.047 vs 0.230±0.031 ).The expression of apoptosis promoting factor Bax wasslightly up-regulated.The blockage of JAK/STAT pathway cotld down-regulate the expression levels of the gene and protein of survivins Bcl-2 and Bcl-xl,and up-regulate the gene and protein expressions of Bax.Conclusion In the process of RA development,apoptosis inhibitor Bcl-2,Bcl-xl gene and protein expression is up-regulated.JAK/STAT signal transduction pathway regulates the apoptosis process.

Objective To explore how does chymase affect diabetic cardiomyopathy by investigating the gene expression of chymase and the relationship between the gene expression of chymase and the angiotensin Ⅱ in the cardiomyopathy of streptozotocin-induced diabetic hamasters. Methods Diabetic hamsters were induced by intraperitoneal injection of STZ 40 mg/kg once a day for 3 days. After stabilization of diabetic state for 18 weeks, the myocardial ultrastructure was observed with electron microscope and pathologic changes were observed by light microscopy. Immunohistochemistry was used to measure the level of expression of type Ⅰ and type Ⅲ collagen in diabetic and normal hamster hearts. Level of blood glucose, lipoprotein was determined using biocehemical methods. Apoptosis of cardiomyocyte was measured using TUNEL methods. Radioimmunuoassay method was used to determine the level of angiotensin Ⅱ. RT-PCR was used to determine chymase gene expression (corrected by?-actin). ResultsComparing with the control group, levels of serum glucose, TG, TC, LDL in DM group were much higher. Concentrations of collagen Ⅰ, Ⅲ and angiotensin Ⅱ [(95.8?16.0)?g/kg tissue vs (51.1?20.8)?g/kg tissue] in myocardial tissue in DM group were much higher than those in control group. RT-PCR result showed: Comparing with the control group, the mRNA expression of chymase in DM group was promoted significantly (0.810?0.026 vs 0.490?0.087). Conclusion In diabetic hamsters, the gene expression of chymase were much higher than thatin the control group, accompanying higher level of Angiotensin Ⅱ, higher levels of expression of collagen Ⅰ and Ⅲ. This result suggests that chymase plays an important role in the diabetic cardiomyopathy by promoting the activity of chymase.

Objective To clear the coping process of ischemic stroke patients and their families before the onset,explain its response rules and the influence factors,and provide scientific basis for the construction of comprehensive stroke pre-hospital intervention program.Methods A semi-structured interviews were conducted with 10 cases.Data were analyzed using the grounded theory.Results Ischemic stroke patients and their families at the onset process experienced recognition,reaction,alert and action stage.Conclusion Health education should be combined with the whole process of ischemic stroke patients and their families before hospital,building a comprehensive intervention program.

Objective: To investigate the mechanism responsible for homoharringtonine (HHT), which contributes to imatinib (IM) sensitivity in the chronic myeloid leukemia (CML) cell line. Methods:We established cell lines from a patient with CML at the time of first diagnosis and relapse phase, and designated the cell lines as NPHA1 and NPHA2, respectively. Stable underexpressed EphB4 cells (NPHA2-EphB4-sh) were obtained. Leukemia cell lines were incubated with HHT. The activated signal proteins in cells were tested by Western blot. Results:EphB4 was overexpressed in IM-resistant NPHA2 compared with the NPHA1 cell line. However, the expression of EphB4 mRNA and protein were significantly decreased in knockdown NPHA2-EphB4-sh cells compared with the NPHA2 and NPHA1 (P<0.001) cell lines. NPHA2-EphB4-sh cells were sensitive to IM (IC50:0.93 mg/L), and NPHA2 showed IM re-sistance (IC50 : 5.45 mg/L) (P<0.001). However, co-stimulation with HHT+IM decreased IC50 of NPHA2 cells to 1.17 mg/L (P<0.001). Meanwhile, phospho-Rac1/cdc42 was significantly increased in NPHA2 cells compared with NPHA2-EphB4-sh (P<0.001). HHT blocked the expression of EphB4/RhoA. Conclusion: The overexpression of EphB4 contributed to IM resistance in CML line cells. EphB4/RhoA may be a new marker of IM resistance. HHT with IM yielded more treatment advantages than IM alone by blocking EphB4/RhoA pathways.